Healthcare Provider Details

I. General information

NPI: 1932390572
Provider Name (Legal Business Name): JAY P JAIKISHEN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 HOSPITAL DR SUITE 406
LAFAYETTE LA
70503-2852
US

IV. Provider business mailing address

501 RIVER OAK CIR
LAFAYETTE LA
70508-6749
US

V. Phone/Fax

Practice location:
  • Phone: 337-232-1171
  • Fax: 337-232-5543
Mailing address:
  • Phone: 337-231-5309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number08029 R
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number08029R
License Number StateLA

VIII. Authorized Official

Name: DR. JAY P JAIKISHEN
Title or Position: PRESIDENT
Credential: MD
Phone: 337-231-5309